Tag Archives: health screening

Welcome to the next part of the male reproductive system and today an overview of the prostate and health issues to be aware of. Also a repeat of the guest post by John Maberry on Prostate cancer and the treatments available.

Prostate problems

As women face problems with their uterus, and possible hysterectomies, so men are faced with problems with their prostates. The good news is that in the majority of cases the conditions are benign, and are not going to lead to cancer, but symptoms should always be checked out.

In a young man the prostate is about the size of a walnut and it slowly gets larger as a man matures. If it gets too large, however, it can begin to cause problems with the urinary tract resulting in frequent urination and in some cases discomfort. This is called benign prostatic hyperplasia (BPH) and is very common in men over 60 years old. If problems with urination occur especially at night then a doctor should be consulted. Usually a rectal examination or scans will detect the enlarged prostate and appropriate treatment prescribed. If the enlargement of the prostate and the urination problems are relatively mild then it is usually left for a period of time to see if the normal reduction in testosterone will result in a decrease in the size of the prostate.

If the enlargement of the prostate or the symptoms warrant medical intervention it is usual to prescribe either alpha-blockers (can have some nasty side effects) or a testosterone lowering drug. As the testosterone levels decrease the prostate shrinks and the urination problems are solved. However there can be side effects such as loss of sex drive and possible erectile problems.

There is a herb called Saw Palmetto that is taken by many men, who have been diagnosed with an enlarged prostate. As always, I prefer the natural approach but it is important that you consult your doctor before taking any herb in preference to medication to ensure that your progress is monitored carefully.

In extreme cases surgery may be advised if the urination problem does not improve. It can however result in other problems and should be considered carefully beforehand.

Now for the guest post by John Maberry author of Waiting for Westmoreland and please feel free to comment and share his post.

PSA Tests—Yes or No by John Maberry

You know about PSA tests, right? A simple blood test that measures the level of prostate specific antigens in the bloodstream. The purpose is to detect the likelihood of cancer. This article is about whether to have one or not. First some background.

The prostate is a walnut sized gland that’s wrapped like a horseshoe around a man’s urethra. It’s primary function is to produce semen. Unfortunately, it can also become cancerous. In the U.S. 1 in 7 men will get prostate cancer in their lifetime. It’s the second leading cause of cancer death among American men, behind only (surprisingly) skin cancer. [American Cancer Society] Sounds scary, but only 1 in 38 men will die of it—a statistical disconnect between cancer-caused and other deaths. How so? Most prostate cancer progresses very slowly and starts after age 50, consequently most men die of something else in their senior years—heart attack, stroke, etc. But if it is cancer that kills them, prostate cancer is #2 on the list.

What about elsewhere in the world? According to 2012 statistics from World Health Organization, the incidence is similarly high in the rest of North America, Australia/New Zealand, Northern and Western Europe—probably because of the high level of PSA testing. Mortality is similar in those developed areas but higher in the Caribbean and most regions of Africa, probably as a result of medical treatment not being as available or affordable.

So, you’re a guy or you have one you care about, what about a PSA test? What follows is a whole lot of discussion of what it is and things for you to consider. But before we get to that, let me give you the bottom line—if you’re like me and have a family history of prostate cancer, ignore generic pros and cons and get the test every year or two.

The test entails drawing a small blood sample from a vein (usually in the arm) and sending it to a lab. What happens after that depends on the PSA level detected. Recently the PSA test has come under scrutiny, with one group in America recommending against routine screening. Others still recommend it. See this website for the pro position. Most other groups focused on men’s health or cancer disagree with the con position and have varying qualifiers related to age and family history—with the final decision to be an agreement between the man and his primary care physician. Medicare, and many private insurers still pay for it. Medicaid may or may not. Why the controversy? It relates in part to the limitations of the test itself and in part to what happens after the results come in. See more on the test at the Mayo Clinic site.

Limitations of the test include:

False positive results due to prostatitis, BPH, urinary tract infection or other conditions

False negatives due to taking certain drugs such as statins, obesity or low PSA despite a tumor

Age—PSA rises with age

The test by itself doesn’t correlate highly with the age-related risk of death from cancer

The risks of side effects from further testing

Side effects from treatment that may not be necessary (see more below on what happens after the test

What happens after the test: If the level is high, a retest may be done. A digital rectal exam (a doctor inserts a gloved in finger in the rectum to feel for hardened lumps on the prostate—which may be done in conjunction with or instead of the PSA test as a routine screening test for BPH (benign prostatic hyperplasia—enlargement of the prostate that is very common as a man grows older; it causes more frequent urination as the gland squeezes the urethra). Beyond that, a whole host of potentially more costly and invasive (not to mention worrisome) procedures may be done:

A test for a urinary tract infection that might inflame the prostate (raising the PSA) as well

A transrectal ultrasound to look for tumors

A biopsy of the prostate (accessed through the rectum, the perineum or up the penis); this procedure itself can have side effects such as bleeding, infection and irritation

If the follow up tests confirm the presence of cancer this is where things get complicated

Is it the typical slow-growing cancer that will cause no problems before you die or the faster growing kind that requires action?

o The Gleason score measures how fast a cancer is growing—it ranges from 2-10, with 10 being quickest and most likely to spread. [My father died of prostate cancer in 1954 at age 48 and it had metastasized widely; my brother had his prostate removed in 1999 at age 68 when an ultrasound confirmed tumors after a high PSA score of 9.9 and a medium Gleason score—he is still alive and kicking at 84] See more on Gleason score here.

You have two basic options—watchful waiting or active surveillance with periodic retests (depends on your age) or treatment to remove the cancer

The bad news: all of the treatments, except possibly the hormone therapy, have a significant risk of urinary incontinence or erectile dysfunction. This is where the issue of overtreatment becomes real and is a core part of the argument against screening—the doctor finds a cancer and the man gets treatment with side effects when if the prostate were left alone the cancer wouldn’t kill him.

So, as noted before, if you’re like me with a family history of prostate cancer the answer is clear—get the test. If you are of African descent, probably should get the test too. In any case, ask your doctor. Don’t stick your head in the sand and hope for the best.

About John Maberry.

John Maberry dreamed of being a writer from second grade. Life got in his way. Like what, you may ask. Find out the details in Waiting for Westmoreland, the memoir he wrote about how he came to have a happy and successful life. That, after surviving a hard childhood, failed marriages, an eye opening year in Vietnam and more. He finished the memoir five years after retiring from a local government job in busy Northern Virginia.

That’s John in the photo, relaxing with his friend Larry the Lizard. He met Larry in Mimbres,
New Mexico. John and his wife relocated to scenic New Mexico six years ago. That move and other priorities, stalled the transition to speculative fiction, mysteries and writing genres. Finally, The Fountain, a collection of speculative fiction stories, is coming out in July, 2017. He’s also working on a few novels, planning for one every one to two years. No more delays, time is fleeting.

When not working on the novels or the websites, the family enjoys life in their dream home high atop a hill. His wife of 35+ years has her quilting/craft room. He has an office shared with an energetic dog who lounges on a loveseat behind him when not out chasing rabbits. He’s a happy man and a funny guy (strange/weird his wife says).

Books by John Maberry

About John’s latest release – The Fountain and six more fantasy & Scifi stories.

Humor, twists and more in this collection of seven fantasy and sci-fi short stories. Karma can be painful in “The Fountain”–when a plunderer meets a long-dead shaman. A family adopts a retriever with special talents in “Lily, an Amazing Dog.” A vampire has a strange problem, in “Alfred’s Strange Blood Disorder.” A perennial favorite, dimensional travel, with a strange twist in “The Closet Door.” What could that column of fire be, rising from the Atlantic off the Outer Banks? Read “The Flame” to find out what it meant to troubled writer Carson. A wizard casts a spell that works well for a princess, but will it be as good for him? Check out “The Wizard.” Finally, “The Fribble” offers an alien encounter of an odd sort, to a pharmaceutical company rep searching for new drugs in the Amazon Rain forest.

If you enjoy short stories in fantasy/sci-fi genres, and stories that make you think then look no further than Maberry’s tales which will engross you with stories about karma, greed, time travel, aliens and muses.

In this book you will read stories about: a dog with extra sensory perception, a writer battling his own sub-conscience, a wizard who wonders if the spells he casts for others will work for himself, a man who experiences 2 lifetimes by opening a closet door. These are just a few of the stories to stimulate your reading appetite.

Maberry is a prolific writer who knows how to keep a reader captivated till the end and finishes his stories with an unexpected twist. This book also offers an excerpt to the author’s next upcoming novel. As in true Maberry style, he leaves us hanging in anticipation with more to come. A great read!

Some of you may have read this during Men’s Health Week last year but I do believe that it is a post worth repeating so that there is an awareness to act sooner rather than later if there is even the slightest change in the way our body behaves.

My father was diagnosed at age 77 with prostate cancer and it was at least stage three. This was twenty-five years ago and the treatment is radiation and lots of it. It gave him time but the last year was very hard on him. The radiation had caused a blood disorder that required him to have a regular blood-transfusions and good naturedly he would present himself at the hospital on the designated Friday.. My father loved his food and the day is significant… they served fish ‘n’ chips. Eventually he required these transfusions weekly and after a short period of time he passed away aged 80.

Today there have been huge advancements in the detection and treatment of prostate cancer and the prognosis is much improved. But it is dependent on a very important factor and that is early detection.

I explored some very frightening figures after an image was posted on facebook from Just Eat Real Foodthat claimed that from 1900 the risk of developing cancer had increased dramatically from 1 in 30 to 1 in 2. Many people thought that this could not be true. Well it appears that it well might be.

In the UK, Cancer Research UK states that for those born after 1960 there is a 1 in 2 chance of developing a cancer of one type or another… This will be reflected in other countries who have adopted a highly industrialised food chain which includes mass farming methods and chemical and hormonal ‘enhancements’ at each phase of the production process.

We all have rogue cells that are pre-cancerous but if we have a strong immune system these cells either self-distruct or are contained by our own defences.

However, if those defences are weakened by a nutritionally deficient diet, those actions will not occur and in a sugar rich and oxygen deprived environment, cancer cells will reproduce rapidly.

We are now living longer and as we age so do our cells. As our diet and lifestyle changes in later years, our immune system weakens and the defences are down. It is therefore absolutely possible that 1 in 2 of us will develop some form of cancer in our lifetime. The difference being that cancers that develop in our bodies in our 80s and 90s are likely to grow slowly and outlive us.

As women face problems with their uterus, and possible hysterectomies, so men are faced with problems with their prostates. The good news is that in the majority of cases the conditions are benign, and are not going to lead to cancer, but symptoms should always be checked out.

What is the prostate?

The prostate gland is a very small walnut shaped structure that sits at the base of the bladder and surrounds the ejaculatory ducts at the base of the urethra. Its role is to produce an alkaline fluid that mixes with the semen from the vesicles before it is passed into the penis to be ejaculated. This probably acts as a booster for the sperm keeping them active and therefore more likely to fertilise an egg should the opportunity arise.

In a young man the prostate is about the size of a walnut and it slowly gets larger as a man matures. If it gets too large, however, it can begin to cause problems with the urinary tract resulting in frequent urination and in some cases discomfort. This is called benign prostatic hyperplasia (BPH) and is very common in men over 60 years old.

If problems with urination occur especially at night then a doctor should be consulted. Usually a rectal examination or scans will detect the enlarged prostate and appropriate treatment prescribed. If the enlargement of the prostate and the urination problems are relatively mild then it is usually left for a period of time to see if the normal reduction in testosterone will result in a decrease in the size of the prostate.

If the enlargement of the prostate or the symptoms warrant medical intervention it is usual to prescribe either alpha-blockers (can have some nasty side effects) or a testosterone lowering drug. As the testosterone levels decrease the prostate shrinks and the urination problems are solved. However there can be side effects such as loss of sex drive and possible erectile problems.

In extreme cases surgery may be advised if the urination problem does not improve. It can however result in other problems and should be considered carefully beforehand.

Prostate cancer

Women dread the words breast, ovary or uterine cancer and for men it is prostate cancer. As with most cancers if it is found early then the chances of recovery are very good. Unfortunately the early signs of cancer can be confused with BPH which is why it is an excellent idea to consult a doctor the moment you feel there is a change to your urination in any way. This is especially true if you develop a burning sensation or pain during urination or there is blood present in the urine. Sometimes there could also be blood in semen, pain in the back, hips or pelvis and painful ejaculation. There can also be an innocent and harmless cause of some of these symptoms but it is important to clarify the situation immediately with your doctor.

Apart from a physical examination a doctor will also conduct a blood test to determine the levels of prostate-specific antigen (PSA). These may be higher in men with either an enlarged prostate or cancer and it is backed up by an ultrasound to establish any abnormalities in the gland.

Usually a biopsy is necessary to confirm the diagnosis and is commonly done by the doctor under local anaesthetic.

Treatment

These days if the cancer is in the early stages and slow growing it will be monitored regularly to determine if the next stage in the treatment is necessary. Treatments are being refined and reviewed continually and your doctor will have the latest information at hand.

The most common type of surgery is a radical prostatectomy where the whole prostate and some surrounding tissue is removed. This may result in loss of sexual function or urinary problems that may not correct themselves. There is a modified operation that reduces the risk of nerve damage and therefore impotence that some men will be offered if appropriate.

Radiation treatment is used in some cases prior to surgery to kill cancerous cells and shrink the tumour and following surgery to ensure that all harmful cells have been eliminated. There are two kinds of radiation, externally beamed into the prostate and internally where radioactive “seeds” are placed in the prostate itself, into or near the actual tumour. There can be some side effects with this treatment including impotence and incontinence, which will have to be managed in the long term.

Following radiation, patients may be offered hormonal treatment to prevent the cancer from reoccurring or if the cancer has spread to other parts of the body. This will usually result in menopausal symptoms such as hot flushes as well as a loss of sexual desire.

Now to a different perspective on prostate cancer treatment.

This in no way negates the need to get checked, as a physical examination is key to determining if there is a problem with the prostate. Whilst unpleasant (and trust me we women have equally invasive examinations) a few minutes of embarrassment or discomfort is better than years of treatment and doubt about the outcome.

Today treatments are targeted very specifically in the area affected and as you will read a different approach to beginning treatment is usually followed if the cancer is in the very early stages. A ‘watch carefully and wait and see’ strategy is particularly relevant if the patient is in their late 70s and 80s as certain cancers have a less aggressive growth pattern as we age.

Do read the article so that should you face a diagnosis of prostate cancer you can ask all the right questions to ensure that you explore all the options available. Be aware that different consultants have their own approach to specific cancers and whilst the ‘wait and see’ strategy is widely adopted in the UK it may be very different where you live.

This series is not intended to be used as a diagnostic tool..It is however a recommendation to find out about areas of the body which are at risk and to ensure that you notice changes that occur.. Nobody else can do that except perhaps someone close to you. This is why it is so important for partners to also keep an eye out for changes in habits that might indicate that there is a problem.

The sooner that prostate cancer is diagnosed the better the outcome. Get Checked.

You will find other posts in the A – Z of Common Conditions in the directory.